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  • 101.
    Arnesson, Annelie
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Hedlund, Nina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Upplevelsen av arbetsmiljö i öppna kontor inom IT-sektorn: - En kvalitativ intervjustudie2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim:

    The aim of the study was to describe the experience of working environment in open plan office within IT- sector.

    Background:

    Previously was the most common office model cell office, open plan office is now the most common. A good working environment in theise two office types needs different attributes. A theory to explain relationship between health and unhealth is Karasek and Theorells demand- control- supportmodel.

    Method:

    A qualitative interview study was performed to gain a deeper understanding of the experience of working in open plan office within IT- sector. Ten informants from two different organizations were chosen. The result has been analyzed with qualitative content analysis.

    Results:

    The analyses resulted in three themes and six sub-themes. The result showed that there were both positive and negative aspects of working environment in open plan office. Positive aspect was mentioned as good communication and good social interaction while high sound level and disturbing working situation was mentioned as negative aspects.

    Conclusion:

    The result shows that there is many aspects to take in consideration white work in open plan office. To have a good working environment there is need to have a deeper understanding from the organization how the open plan office affect the individual.

  • 102.
    Arnkvist, Pernilla
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Dan, Hammarström
    Umeå University, Faculty of Medicine, Department of Nursing.
    PATIENTERS UPPLEVELSER AV HÄLSOFRÄMJANDE SAMTAL INOM RAMEN FÖR VÄSTERBOTTENS HÄLSOUNDERSÖKNINGAR2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: There are guidelines both globally and nationally to enhance public health. There is currently an ongoing project for enhancing the public health in Västerbotten county called VIP, Västerbotten Intervention Program, where motivational interviewing (MI) has a role to support health enhancing lifestyle-changes. Primary health care nurses are responsible for these health examinations and related health counselling. Caregivers, though are reported to experience difficulties in counselling and use of methods like motivational interviewing because of lack of preconditions for implementation. Health counselling has a potential to enhance patient empowerment and help people to achieve positive lifestyle changes.The purpose of this study was to describe the patient's experiences of health promoting counselling within the Västerbotten Intervention Program.Design: The design of the study was descriptive.Method: Qualitative method. Data was collected during september 2017 using semi-structured interviews analyzed with qualitative content analysis. The target group of this study was people in age 40, 50 and 60 years who had participated in health examinations within VIP the last year. In total, nine persons participated of whom 3 were men.Results: The participants experience from the health examination were described in the two themes: The interaction of the health promoting dialogue were based on closeness as well as distance, and the health promoting counselling created awareness about personal responsibility and need of support.Conclusion: Health promotive counselling seem to have a positive impact on the patient’s health, however it imposes a challenge for both health professionals and the organization, due to the possible need of further education in health dialogue methods that encourage the patient’s empowerment and motivation to change.

  • 103.
    Aronsson, Elin
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Persson, Sandra
    Umeå University, Faculty of Medicine, Department of Nursing.
    Äldre kvinnors upplevelser och erfarenheter av att utsättas för våld i nära relation: En litteraturstudie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Violence against women is a global health problem and the older battered women needs to be more noticed. There are major deficits in the way health care treats this group. More knowledge and understanding are required.Aim: To describe older women’s experiences of being victims of domestic violence.Method: A literature study with eight qualitative articles that were analyzed with qualitative content analysis.Result: Results showed that the experience of insecurity was felt through fear, anxiety, worry, guilt, shame and sexual exposedness. The experience of vulnerability was described through fragility and a loss of self-worth and self-power. The experience of living up to expectations lead to a loss of the own self, but also an inner strength. The experience of living in silence was expressed as an inner pain, a lifelong suffering, alienation and invisibility.Conclusion: Older battered women are suffering and it needs to be acknowledged as a social problem. Future research about how health professionals are using and following resources is needed, but also about why people use violence. The government needs to act and the health care needs concrete acts to provide adequate help

  • 104. Arouca, Aline B.
    et al.
    Santaliestra-Pasías, Alba M.
    Moreno, Luis A.
    Marcos, Ascensión
    Widhalm, Kurt
    Molnár, Dénes
    Manios, Yannis
    Gottrand, Frederic
    Kafatos, Anthony
    Kersting, Mathilde
    Sjöström, Michael
    Sáinz, Ángel Gutiérrez
    Ferrari, Marika
    Huybrechts, Inge
    González-Gross, Marcela
    Forsner, Maria
    Umeå University, Faculty of Medicine, Department of Nursing. School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
    De Henauw, Stefaan
    Michels, Nathalie
    Diet as a moderator in the association of sedentary behaviors with inflammatory biomarkers among adolescents in the HELENA study2019In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 58, no 5, p. 2051-2065Article in journal (Refereed)
    Abstract [en]

    AIM: To assess if a healthy diet might attenuate the positive sedentary-inflammation relation, whereas an unhealthy diet may increase the effect of sedentary behaviors on inflammatory biomarkers.

    METHODS: In 618 adolescents (13-17 years) of the European HELENA study, data were available on body composition, a set of inflammation markers, and food intake assessed by a self-administered computerized 24 h dietary recall for 2 days. A 9-point Mediterranean diet score and an antioxidant-rich diet z-score were used as dietary indices and tested as moderators. A set of low-grade inflammatory characteristics was used as outcome: several cytokines in an inflammatory ratio (IL-6, IL-10, TNF-α, TGFβ-1), C-reactive protein, three cell-adhesion molecules (sVCAM-1, sICAM-1, sE-selectin), three cardiovascular risk markers (GGT, ALT, homocysteine) and three immune cell types (white blood cells, lymphocytes, CD3). Sedentary behaviors were self-reported and analyzed as total screen time. Multiple linear regression analyses tested moderation by diet in the sedentary behaviors-inflammation association adjusted for age, sex, country, adiposity (sum of six skinfolds), parental education, and socio-economic status.

    RESULTS: Both diet scores, Mediterranean and antioxidant-rich diet, were significant protective moderators in the effect of sedentary behaviors on alanine-transaminase enzyme (P = 0.014; P = 0.027), and on the pro/anti-inflammatory cytokine ratio (P = 0.001; P = 0.004), but not on other inflammatory parameters.

    CONCLUSION: A higher adherence to the Mediterranean diet or an antioxidant-rich diet may attenuate the onset of oxidative stress signs associated by sedentary behaviors, whereas a poor diet seems to increase inflammation.

  • 105.
    Arvidsson Kälverot, Sarah
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindgren, Sanna
    Umeå University, Faculty of Medicine, Department of Nursing.
    Reducering av stråldos vid angiografier och endovaskulära interventioner: En litteraturstudie om metoder för ökad strålsäkerhet2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Reducering av stråldos vid angiografier och endovaskulära interventioner-En litteraturstudie om metoder för ökad strålsäkerhet

    Bakgrund: Angiografier och endovaskulära interventioner är patientgynnande undersökningar och behandlingar som till skillnad från kirurgi innebär mindre risk för komplikationer samt en kortare läkningstid. Längre genomlysningstid och ökat antal exponeringar medför dock en högre risk för oönskade strålskador hos patienten.

    Syfte: Litteraturstudiens syfte var att beskriva metoder för att reducera stråldosen till patienter som genomgår angiografier samt endovaskulära interventioner.

    Metod: Syftet besvarades i en litteraturstudie. 10 kvantitativa studier analyserades och sammanställdes. Sökning av studier genomfördes i databasen Pubmed.

    Resultat: Materialet bearbetades samt delades in i två domäner: metoder gällande personalen samt metoder gällande utrustningen. Resultaten som innefattade stråldosreducerande metoder presenterades som kategorier.

    Konklusion: Att ha uppdaterad och utbildad personal resulterar i miljö med högre patientsäkerhet. I takt med att teknologin utvecklas bör verksamheten se över sina behov och prioritera fortsatt utbildning av personal samt investera i anpassad utrustning. Fortlöpande forskning är viktig för att utvärdera effekter av den nya teknologin och röntgensjuksköterskor kan bidra med kompetens inom området.

    Nyckelord: Angiografi, Endovaskulär intervention, Strålskydd, Patientsäkerhet.

  • 106.
    Arvidsson, Mikaela
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sjöström, Felicia
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sjukvårdspersonals erfarenheter av att bemöta barn vid misstanke om fysisk misshandel: En litteraturstudie2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Child abuse causes suffering to the child which can have long-termconsequences. Healthcare professionals must be observant and report on suspicion of child abuse. When an abused child needs care, the healthcare staff’s approach plays a major role. Aim: To highlight the healthcare professionals’ experiences of responding to children and their relatives in connection with suspicion of physical child abuse. Method: A qualitative method has been used in this study where the selection has also been based on qualitative studies. The study is written from the healthcare professionals’ perspective to gain an understanding of their experiences. Searches were made in PubMed, CINAHL and Scopus. Result: The result is based on three categories: To feel safe in their profession, To experience emotional stress and To realise the importance of support. The main result show that healthcare professionals can maintain a professional way of working with children who have been abused and their family, if they get support for managing their feelings. Conclusion: By providing support and education and improving cooperation between different professions, healthcare professionals can develop their approach for children who have been abused and their relatives.

  • 107.
    Asp, Christin
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Öhman, Mona
    Umeå University, Faculty of Medicine, Department of Nursing.
    Barnmorskestudenters upplevelse av förberedelse, stöd och handledning: gällande verksamhetsförlagd utbildning2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    AbstractObjective: To study the student midwife’s experiences of preparation for clinical practice, and of support and supervision during the clinical practice at the delivery ward.Method: A descriptive cross-sectional study with quantitative and qualitative approach was performed. Data was collected through 171 questionnaires. The results were analyzed by descriptive and comparative statistics where the significance level was set to p < 0.05. Qualitative data was analyzed by manifest content analysis. As a theoretical framework, the “International Code of Ethics for Midwives” was used.Participants: Active students in their third semester at midwifery education (n = 80), and midwives with a degree in June 2016 or January 2017 (n = 91), across all universities in Sweden.Findings: The respondents in the study indicated that midwifery education is too short and intensive. Continuity regarding preceptor was found to be important for the students, but difficult to accommodate in the delivery ward. Active students were compared to newly-examined midwives more often supervised by temporary staff (p < 0.05). Generally, the respondents wished for more clinical practice, both of acute and non-acute conditions that may occur in the delivery ward. In addition, they desired more time for reflection, in groups or individually with preceptors, to process emotions and consolidate their skills.Conclusion: To provide a safe learning environment for the student where he/she is allowed to step up and develop the opportunity to excel in midwifery, experienced preceptors are required to convey knowledge and values, as well as provide support to the student during the demanding education. The student needs regular time allocated for reflection, in groups or individually with supervisors, to process emotions and consolidate their knowledge. The lack of experienced midwives is thought to be one reason that students are more widely assigned to temporary preceptors now in comparison to the last year.Clinical Implications: This study may give an indication of the coping of midwife students during the education at the delivery ward. Many students wish for extended education, which is also discussed by the national federation of midwives, the institutions of higher education and the education board

  • 108.
    Aspevall, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Molin, Anna
    Umeå University, Faculty of Medicine, Department of Nursing.
    En kvalitativ studie som undersöker arbetande personers uppfattningar och erfarenheter om sjuknärvaro på arbetet2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Sjuknärvaro innebär att gå till jobbet trots sjukdom. Sjuknärvaro är ett förekommande problem, även internationellt. Det finns många faktorer som bidrar till sjuknärvaro,som individuella egenskaper och arbetsplatsfaktorer. Sjuknärvaro bidrar till högre sjukfrånvaro och ohälsa hos arbetstagare. Sverige och Norge har starka sociala skyddssystem vid sjukdom. I Sverige finns karensdag vid sjukfrånvaro.

    Syfte: Att undersöka arbetande personers uppfattningar och erfarenheter om sjuknärvaro på arbetet.

    Metod: Totalt 12 kvalitativa intervjuer har genomförts i Sverige och Norge. Hälften av deltagarna är kvinnor och hälften är män med olika yrken. Informanterna har valts ut genom bekvämlighetsurval. Kvalitativ innehållsanalys har använts vid analys av textmaterialet.

    Resultat: Hälsa och sjukdom är subjektiva begrepp och människor har olika tröskel för bedömning av sjukdom. Individens egna känslor och personlighet är drivkrafter till sjuknärvaro. Många ägnar sig åt självrannsakan före en sjukskrivning.Sjuknärvaro kan medföra risker för kollegor och för arbetsplatsen. Sjukfrånvaro anses få konsekvenser för andra människor och även för individen själv, vilket bidrar till sjuknärvaro.Yrke och arbetsuppgifter har betydelse för sjuknärvaro. Fysisk och psykosocial arbetsmiljö och arbetsplatskultur är också faktorer som spelar in. Samhällsfaktorer som bidrar till sjuknärvaro är samhällsklimatet, ekonomiska faktorer och brister i sjukförsäkringssystemet.

    Diskussion:Sjuknärvaro är ett problem i samhället som inte bara påverkar individen utan hela arbetsgruppen,arbetsplatsen som organisation och samhället i stort. Det finns många anledningar till att människor går sjuka till jobbet. Forskning behövs för att komma till rätta med detta problem.Forskning behövs också för att internationellt sett stärka arbetstagares rättigheter och villkor,arbetsgivarens skyldigheter och samhällets ansvar.

  • 109.
    Aspioti Delija, Alexandra
    Umeå University, Faculty of Medicine, Department of Nursing.
    Hur upplever sjuksköterskor som arbetar på en häloscentral mötet med ambulanspersonal?2018Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Nurses in healthcare clinics often meet patients that has searched care from the wrong care level and therefor need to be transported with ambulance to the nearest hospital.

    Motive: For the patient to achieve good care and for a high safety of the patient, it is important that all parts of the care-chain function and that the handover process is of good quality.

    Aim: The aim of this study was to elaborate how nurses from health care clinics experience the encounter with ambulance staff in connection to the handover of the patient.

    Method: The study used a qualitative research design with an inductive approach. Data was collected through semi-structured interviews. Eight nurses working in healthcare clinics in Norrbotten was interviewed during March and April 2018. The criteria for participating in the study was a minimum of one-year work experience in a healthcare clinic and that they had participated in encounters with ambulance staff. The interviews were transcribed verbatim and analyzed with a qualitative content analysis.

    Result: The result was presented in three main categories: Difficulties in understanding each others competence; To have control over the situation, and To encounter conversation. The nurses experienced that the ambulance staff is very competent but that they often felt being a lower rank insecure in their presence. They experienced that they often were challenged and that their judgement tocontact the ambulance was wrong. There were some positive experiences when the encounter went smooth, and the nurses had enough time to prepare the patient for departure before the ambulance staff arrived.

    Discussion: To feel insecure at work can lead to a worsened work environment and may affect patient safety. To strive for a safe patient care should be the goal for both professions. Earlier experiences matters in how the encounters with ambulance staff could go. Good teamwork and respect for one another’s competence matters. A structured reporting procedure is a key-component for not loosing important information. Every encounter is unique and require communication ability and flexibility.

    Conclusion: The understanding of each other’s competence needs to improve. More studies, highlighting the experiences from different perspectives may increase the understanding. Inviting to encounters between the two departments may contribute to a better understanding and a better teamwork.

  • 110.
    Asplund, Kenneth
    Umeå University, Faculty of Medicine, Department of Nursing.
    The experience of meaning in the care of patients in the terminal stage of dementia of the Alzheimer type: interpretation of non-verbal communication and ethical demands1991Doctoral thesis, comprehensive summary (Other academic)
  • 111.
    Astergren, Lina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Winter, Emelie
    Umeå University, Faculty of Medicine, Department of Nursing.
    Intensivvårdssjuksköterskors erfarenheter av att vårda patienter under Extracorporeal Membran Oxygenering (ECMO) behandling2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att undersöka intensivvårdssjuksköterskors erfarenheter av att vårda patienter under Extracorporeal Membran Oxygenering (ECMO) behandling.

    Bakgrund: Intensivvårdssjuksköterskor har som arbetsuppgift att ta hand om kritiskt sjuka patienter. Patienter som har behov av ECMO behandling har ökat och används när ingen annan behandling har visat sig fungera. ECMO är en komplex behandling och ställer höga krav på intensivvårdssjuksköterskor. Det krävs specifika kunskaper och förmågor att handha avancerad apparatur, planera, prioritera och samarbeta runt patienten.

    Design: En kvalitativ intervjustudie.

    Metod: Kvalitativa intervjuer med semistrukturerade frågor genomfördes med nio intensivvårdssjuksköterskor på en intensivvårdsavdelning i Sverige 2016. Intervjuerna analyserades genom kvalitativ innehållsanalys.

    Resultat: Det analyserade materialet resulterade i två kategorier: omständigheter i arbetet för en otrygg och riskfylld vård, förutsättningar i arbetet för en trygg och säker vård. De två  kategorierna resulterade i sju subkategorier.

    Konklusion: Intensivvårdssjuksköterskors erfarenhet av att vårda patienter med ECMO är att det är en utmanande, krävande och komplex patientgrupp att vårda. Intensivvårdssjuksköterskorna önskar kontinuerlig utbildning och större patientflöde för att minska otryggheten och få en fördjupad kunskap av patientkategorin.

     

  • 112.
    Atri, Arash
    Umeå University, Faculty of Medicine, Department of Nursing.
    Kommunikationsstrategier mellan vårdare och patienter utifrån ett mångkulturellt perspektiv2014Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Den ökade immigrationen till Sverige under senaste decennier har inneburit en ökning av antalet patienter med invandrarbakgrund som söker vård. Detta betyder att röntgensjuksköterskor oftare kommer att träffa patienter med utländsk härkomst. Kommunikation är en röntgensjuksköterskas viktigaste verktyg och utgör grunden till alla mänskliga möten. Det kan bli problematiskt när patienten inte behärskar svenska språket och ska kommunicera med vårdare. Detta ställer krav på röntgensjuksköterskor att hitta lämpliga strategier för att kunna kommunicera med patienten på bästa möjliga sätt. Syfte: Syftet med litteraturstudien var att belysa vårdarens strategier vid kommunikation med personer av utländsk härkomst som inte behärskar det svenska språket. Metod: Metoden var litteraturstudium med kvalitativ ansats, sökningen på artiklarna har gjorts i databaserna CINAHL och PubMed och litteraturstudien baseras på åtta vetenskapliga artiklar som har analyserats med innehållsanalys. Resultat: Analysen resulterade i två kategorier och fem subkategorier. Kategorierna var tolk och icke-verbal kommunikation. Slutsats: Röntgensjuksköterskor har ett ansvar att erbjuda jämlik vård på lika villkor till alla. Därför ska de använda olika strategier för att kunna kommunicera med patienter som inte talar samma språk. Resultatet visade att professionell tolk var den bästa och säkraste metoden för kommunikation med sådana patienter. Därför finns det ett behov av utbildning för röntgensjuksköterskor angående tolkbokning. Dessutom finns det ett behov av tydliga rutiner för att förbättra tolktjänstsystemet när professionella tolkar användas i möten med patienter som inte behärskar språket.

  • 113. Audulv, Åsa
    et al.
    Norbergh, Karl-Gustaf
    Asplund, Kenneth
    Hörnsten, Åsa
    Umeå University, Faculty of Medicine, Department of Nursing.
    An ongoing process of inner negotiation: a grounded theory study of self-management among people living with chronic illness2009In: Journal of nursing and healthcare of chronic illness, Vol. 1, no 4, p. 283-293Article in journal (Refereed)
    Abstract [en]

    Aim. The aim of this study was to better understand the main concern of self-management processes among people with chronic illness.

    Background. One aspect of living with chronic illness is self-management that can reduce the illness impact on daily life and promote future health. Although factors that influence self-management have been identified in previous research, little attention has been brought to the process of making self-management decisions. In clinical settings, use of a theory could facilitate patient-empowering approaches.

    Method. The data collection for this Grounded Theory was mostly conducted in 2006. Data were collected by interviews with 26 adults with a variety of chronic illnesses, including rheumatoid arthritis, diabetes mellitus, inflammatory bowel syndrome, multiple sclerosis, ischaemic heart disease and chronic kidney failure.

    Results. Individuals are conflicted by competing preferences when taking decisions about self-management. Consequently, the decision-making process can be understood as an ongoing inner negotiation between different incompatible perspectives, e.g. social needs vs. medical needs. The process of negotiating self-management starts with the individual's considering beliefs about health and illness, which make the individual face illness threats and the need for self-management. Several aspects influence negotiating self-management namely, assessing effects of self-management; evaluating own capacity; perceiving normality or stigmatisation; and experiencing support and external resources. The process has been demonstrated in a model.

    Conclusions. The process of negotiating self-management is an ongoing inner debate rather than a one-time decision. This opens up new ways of understanding, and communicating with, patients. The described model also links behavioural theories and research findings in a comprehensive understanding.

    Relevance to clinical practice. This model could be applicable as a communication tool for health-care providers in identifying barriers to, and resources in, self-management behaviour among individuals with chronic illness.

  • 114.
    Aurö, Aurora
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Stenman, Lina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Att anmäla till socialtjänsten vid misstanke om att ett barn far illa: En svår uppgift för sjuksköterskor2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Omvårdnad är en viktig del i sjuksköterskans arbete och enligt svensk lag har barn rätt till god omvårdnad och trygghet. Hälso- och sjukvårdspersonal har skyldig­het att omedelbart anmäla till socialtjänsten när de i sin verksamhet får kännedom om eller misstänker att ett barn far illa. Det finns många oklarheter när det gäller sjuksköterskors kunskap, vilja att anmäla och hantering av anmälningar. 

    Syfte: Syftet med studien var att beskriva sjuksköterskors upplevelser av barn som far illa och att anmäla detta till socialtjänsten. 

    Design: Studien genomfördes med en kvalitativ metod. 

    Metod: Studien genomfördes på två pediatriska avdelningar i norra Sverige. Materi­alet samlades in vid 10 intervjuer, och analyserades med induktiv innehållsanalys. Stu­dien utfördes under våren 2015. 

    Resultat: Tre teman och åtta subteman identifierades: (1) Att ta sig an en svår uppgift: Mod att anmäla, Svårt att identifiera barn som far illa, Rädsla för att ha anmält i onödan, Osäkerhet på grund av kunskapsbrist, (2) Att arbeta med kollegor och familjer: Vikten av stöd från kollegor, Vikten av att bevara en god relation till familjen, (3) Att ha bristande förtroende för socialtjänsten: Känslan av att anmälan inte tas på allvar, Samarbete med socialtjänsten. 

    Slutsats: Att anmäla till socialtjänsten om att ett barn far illa är en svår uppgift som präglas av osäkerhet, vilket kan leda till att anmälan uteblir. Det är många faktorer som påverkar sjuksköterskan, kunskapsbrist, dåligt förtroende för socialtjänsten, en önskan om att bevara en god relation med familjen och samarbetet med kollegor.

  • 115.
    Autrieb, Alexandra
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Bernsand, Veronica
    Umeå University, Faculty of Medicine, Department of Nursing.
    Anestesisjuksköterskors strategier för att skapa trygghet hos patienter inför anestesi.2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The majority of patients that are going to need anesthesia before surgical procedures are afraid of being anesthesised and the surgical procedure awaiting. It is difficult to define what security for the patient is and how it can be created for the individual, as this can vary from individual to individual. The sense of security is an important part of health and wellbeing and is included as a criteria for health and medical care, that is included in Swedish hälso och sjukvårds lagen. According to this, so must medical care meet the need of the patient security during care. It is important that the anesthesia nurse understands and realizes the importance of the feeling of security for the patient, and so enables him/her to give increased security when needed.Aim: The Aim of this study was to examine the anesthesia nurses strategies for create a sense of security in patients before anesthesia.Method: This study consist of a qualitative content analysis with an interview guide based on semi-constructed questions. Twelve anesthesia nurses from three different hospitals in the west of Sweden were interviewed.Result: The result builds upon three main categories: Communication, With help of outer factors and personalized care.Conclusion: To adapt the meeting from the patient perspective was as important to create a sense of security. The anesthesia nurse created a sense of security through communication by informing the patient and through body contact. A sense of security was also created through the anesthesia nurses approach to the patient, good team work and through medications. An important aspect to create a sense of security was to let a next of kin be a support.Key words: anesthesiology, sense of security, pre-operative,patient.

  • 116.
    Avander, Tina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Ingesson, Ida
    Umeå University, Faculty of Medicine, Department of Nursing.
    Upplevelsen av hot och våld: En litteraturstudie om vårdpersonalens upplevelser av att bli utsatt för hot och våld inom hälso- och sjukvården2014Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Threats and violence against healthcare workers is today a growing problem worldwide. Healthcare personnel are at an increased risk of being subjected to threats and violence by their patients. Health workers are caregivers and advocates for their patients and if they become subject to threats or violence, previous research has shown that the consequences can be many both for caregivers and patients.

    Aim: The aim of this study was to illuminate the experiences of threat and violence by patients on healthcare personnel. Method: This literature review study included 8 scientific, qualitative articles compiled and analyzed with a description of qualitative content analysis with inductive approach. Article search was performed in the databases Cinahl, PsycINFO, PubMed and Scopus.

    Results: The results show that the experience of being subjected to threats and violence leads to a lot of strong feelings for the victimized health care worker. Feelings are, for the most part, of negative character and include feeling of threatened and afraid, feeling both anger in general and anger directed toward patients, feeling powerless and feeling hopelessness and depression. Threats and violence also lead to other negative consequences for the staff. These include, among other things, that motivation is lowered, and that workers find themselves “taking their work home with them”, which affects their private lives, often in detrimental ways. Affected workers also expressed a strong desire for support for victims, and knowledge and training for coping skills and tactics for dealing with difficult patients.

    Conclusion: The results of the literature review study shows that the experience of being subjected to threats and violence leads to many serious consequences for those who are affected. In order to improve the management of the consequences, education and support for healthcare personnel and further research in the area, to be able to prevent further incidents and help the healthcare workers who have been subjected, are required. 

  • 117.
    Avander, Tina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Ingesson, Ida
    Umeå University, Faculty of Medicine, Department of Nursing.
    Upplevelsen av hot och våld: En litteraturstudie om vårdpersonalens upplevelser av att bli utsatt för hot och våld inom hälso- och sjukvården2014Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    ABSTRACT

     

    Background:Threats and violence against healthcare workers is today a growing problem worldwide. Healthcare personnel are at an increased risk of being subjected to threats and violence by their patients. Health workers are caregivers and advocates for their patients and if they become subject to threats or violence, previous research has shown that the consequences can be many both for caregivers and patients.

    Aim: The aim of this study was to illuminate the experiences of threat and violence by patients on healthcare personnel.

    Method: This literature review study included 8 scientific, qualitative articles compiled and analyzed with a description of qualitative content analysis with inductive approach. Article search was performed in the databases Cinahl, PsycINFO, PubMed and Scopus.

    Results: The results show that the experience of being subjected to threats and violence leads to a lot of strong feelings for the victimized health care worker. Feelings are, for the most part, of negative character and include feeling of threatened and afraid, feeling both anger in general and anger directed toward patients, feeling powerless and feeling hopelessness and depression. Threats and violence also lead to other negative consequences for the staff. These include, among other things, that motivation is lowered, and that workers find themselves “taking their work home with them”, which affects their private lives, often in detrimental ways. Affected workers also expressed a strong desire for support for victims, and knowledge and training for coping skills and tactics for dealing with difficult patients.

    Conclusion: The results of the literature review study shows that the experience of being subjected to threats and violence leads to many serious consequences for those who are affected. In order to improve the management of the consequences, education and support for healthcare personnel and further research in the area, to be able to prevent further incidents and help the healthcare workers who have been subjected, are required.

  • 118.
    Axberg, Madelene
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Olsson, Cecilia
    Umeå University, Faculty of Medicine, Department of Nursing.
    Patienters upplevelse av att leva med trycksår: En litteraturstudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    ABSTRAKT

    Titel: Patienters upplevelse av att leva med trycksår.

    Bakgrund: Trycksår är en skada som uppkommer i den underliggande vävnaden eller i huden. Ett trycksår kan vara en indikation på ett bristfälligt tillvägagångssätt vid bedömning, att patienten är inaktiv eller sängliggande. Trycksår delas in i fyra stadier och kan snabbt utvecklas till högre grad om inte rätt behandling sätts in i tid. 

    Syfte: Syftet var att studera patienters upplevelser av att leva med trycksår.

    Metod: En litteraturstudie genomfördes vars resultat av åtta kvalitativa vetenskapliga artiklar granskades, analyserades och slutligen sammanställdes. Detta genomfördes med inspiration av metaanalys.

    Resultat: Trycksår påverkade patienternas livskvalité där smärta var ett återkommande problem. Detta behandlandes ofta med analgetika, vilket sällan hade någon effekt. Patienterna påverkades fysiska, psykiska och socialt. Sjuksköterskornas roll och hur de informerade var avgörande för hur en patient uppfattade vad trycksår var.

    Konklusion: Trycksår kan förebyggas och förhindras med rätt insatta åtgärder. En rodnad på huden kan vara början på något smärtsamt. Lyssna på patienten, behandla och utvärdera åtgärder. Ingen ska behöva drabbas av den smärta och den förändrade livskvalitén som patienterna upplevde.

    Nyckelord: Trycksår, upplevelse, livskvalitet

  • 119.
    Axelsson, Andreas
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Norberg, Magdalena
    Umeå University, Faculty of Medicine, Department of Nursing.
    Anhörigas upplevelse av att vårda en närstående i livets slutskede i hemmet med stöd av vårdpersonal.: -En litteraturstudie.2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Relatives possess a significant role in the maintenance of palliative care at home. Relatives often assume a caregiving role to sick loved ones without understanding the implication. It is important for healthcare staff to recognize and meet the needs of relatives so they can cope with the burdensome role.

    Aim: To describe relatives' experience of caring for a loved one in end of life at home with the support of healthcare staff.

    Method: A literature study was conducted. Eight qualitative studies were examined and compiled through content analysis.

    Result: The summarized result formed four categories: Positive experiences of caring for a loved one at home, Negative experiences of caring for a loved one at home, Experiences of support from the healthcare staff and Experiences of lack of support from healthcare staff.

    Conclusion: Relatives expressed both positive and negative experiences of the caregiving role. Healthcare staff have an important task in strengthening caregivers through adequate support. A family-focused approach can facilitate and promote a good palliative care at home.

  • 120.
    Axelsson, Ann-Sofie
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Mässing, Carolina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Föräldrars upplevelser av att få ett kroniskt svårt sjukt barn - inriktning på primär immunbrist2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Varje år föds ett till två barn med svår primär immunbrist i Sverige. Studier på föräldrar till barn med andra kroniska sjukdomar visar på att kontakten med olika vårdinstanser var en viktig faktor för deras förmåga att hantera situationen. Föräldrarna beskrev hur den både kunde hindra och stödja deras vårdande roll. Syftet med denna studie är att belysa föräldrars upplevelser av att få ett kroniskt svårt sjukt barn med primär immunbrist och deras kontakt med vården.Metod/Analys. Tio informanter medverkade, en fader och nio mödrar. Intervjustudien genomfördes med narrativ ansats och analyserades med kvalitativ innehållsanalys. Resultat. I resultatet framkom upplevelsen av en kamp för att bli tagna på allvar när det gällde oron över sitt barns symptom och att få rätt vård. Ofta har de stött på okunskap inom vården. Diagnosen var för många en vändpunkt då de upplevde att de fick den vård de länge sökt efter. Informanterna har upplevt vårdens positiva och negativa sidor, vilket resulterade i att de kunde ge önskemål på förbättringsområden inom vården. Konklusion. Resultatet visade att majoriteten av föräldrarna kastats mellan hopp och förtvivlan i sin kamp för att bli tagna på allvar och få sitt barn under rätt vård. Detta visar på att det finns förbättringsområden inom svensk sjukvård som skulle kunna underlätta dessa föräldrars upplevelse. Att få en engagerad omvårdnadsansvarig sjuksköterska som fungerade som spindeln i nätet, möta rätt kunskap ochkontinuitet, få psykosocialt stöd, bra information samt tidig diagnos var faktorer som hjälpte informanterna att hantera situationen.

  • 121.
    Axelsson, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Eating problems and nutritional status after stroke1988Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Eating problems and nutritional status were studied in a consecutive series of 104 stroke patients admitted to emergency hospital care. During their stay in hospital eating problems were observed in 46 patients. Certain common types of eating problems were identified: aberrant eating behaviour as regards chewing,lokalization or swallowing, eating small amounts, hoarding of food in the mouth, leakage of food from the mouth and unawareness of eating problems. Poor nutritional status occurred in 16 % of the patients on admission and in 22 % on discharge from the stroke unit.

    A subgroup of 32 patients hospitalized for 21 days or longer was studied for three weeks. On at least one occasion during these three weeks a poor nutritional status was observed in 18 patients, of whom 17 had eating problems.

    All subjects who had eating problems during their hospital stay, plus those patients without eating problems but with neurological deficits and those living in a nursing home one year after the stroke (n=36) were selected for a longitudinal study 18 months after the onset of stroke. Eating problems were identified in 23 of these patients during their hospital stay while 21 had such problems when they were followed up.

    Two patients who could not eat due to severe dysphagia (after a stroke) for three years and 18 months respectively, were successfully trained to eat normally. One patient exhibited impaired oral and hypopharyngeal function and the other impaired hypo- pharyngeal function and a spastic crico-pharyngeal muscle. In both patients training in swallowing was the main remedical measure and one of them also had a myotomy of the spastic muscle.

  • 122.
    Axelsson, Sofia
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Persson, Emelie
    Umeå University, Faculty of Medicine, Department of Nursing.
    Operationssjuksköterskors erfarenheter av att handleda operationssjuksköterskestudenter2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Preceptoring is about to improve the theoretical knowledge through practical exercise, to make the student familiar with the practical work and be able to create an exchange of knowledge and a need to learn more. The healthcare environment in an operating department is high-tech and complex. Studies show that preceptors often experience a lack of time and operating theatre nurses’ experience that teaching in an operating department takes place in a pressurized environment.Motive: There is no major study that focuses exclusively on preceptoring of operating theatre nurse students; hence it is important to highlight the importance of the preceptor’s role and its experiences of precepting operating theatre nurse students.Aim: To illustrate operating theatre nurses’ experiences of preceptoring operating theatre nurse students. Methods: An interview study with qualitative design and inductive approach. Nine operating theatre nurses were interviewed with semi-structured questions. Qualitative content analysis has been used to analyse the interview text.Results: The analysis resulted in two categories that were referred as ‘Prerequisites for good precepting’ with five sub-categories and ‘Obstacles to good precepting’ with four sub-categories.Discussion: In the discussion, the results are deepened with the support of the Tveitens model for professional guidance. Preceptoring operating theatre nurse students can develop their own professional practice, partly through self-reflection but also by learning together and by the student. If the preceptor and the student have different focus, insecurity can be created for both preceptor and student, which does not benefit the student’s learning.Conclusion: Preceptoring can be seen as a mutual learning where the foundation is based on a safe and permissive environment. Obstacles in preceptoring can make mutual learning more difficult.

  • 123.
    Backlund, Emma
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lilja, Felicia
    Umeå University, Faculty of Medicine, Department of Nursing.
    Livspartnerns upplevelse av att leva med en partner med demenssjukdom2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In Sweden, eight percent of all people by the age of 65 years or older have a dementia disease. The healthy spouse received or unconsciously took the role as caregiver in the home which could cause psychological and physical stress. Therefore it is important that nurses have good understanding of how the healthy spouses experience their life situation.

    Aim: The aim of this study was to describe spouses´experiences of living with a partner with dementia disease.

    Methods: This literature study was performed with a qualitative method. Nine scientific articles have been quality checked and analyzed with inspiration from Friberg´s way of thinking. The databases Cinahl and PubMed were used.

    Results: The literature study resulted in the construction of five categories followed by 13 subcategories. The result of the literature study shows that the healthy spouses are affected physically and mentally by living with a partner with dementia disease. A change in the life situation, which entails that the healthy spouse must adapt and change everyday life for the dementia suffering partner's abilities and skills. Conclusion: Living with a partner with dementia disease means a strain for the healthy spouses. It is important for nurses to pay attention to the healthy spouses´well-being. By this study the nurses hopefully understand that it is important to focus on both partners´ needs.

  • 124.
    Backman, Annica
    Umeå University, Faculty of Medicine, Department of Nursing.
    Leadership: person-centred care and the work situation of staff in Swedish nursing homes2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Swedish nursing home managers, who constitute the empirical focus of this thesis, hold overall operational responsibility for the nursing homes, which includes the care of residents, direct care staff and work environment. Aged care organisations are also expected to provide person-centred care. Working towards a person-centred approach poses new demands and leads to challenges for leaders, and there is currently limited knowledge of what characterises leadership that promotes a person-centred approach. In addition, an ongoing demographic shift in the aged care workforce entails further challenges, as the proportion of professional workers is decreasing. Leading a healthy work environment is therefore important for ensuring and protecting staff health. Based on this, it is important to explore nursing home managers’ leadership in relation to person-centred care and the work situation of staff.

    Aim: The overall aim was to explore leadership in relation to person-centred care and the work situation of staff in Swedish nursing homes.

    Methods: This thesis is based on data from two data collections. First, it includes cross-sectional baseline data from a national inventory of health and care in Swedish nursing homes (SWENIS) collected in 2013-2014. The SWENIS dataset consists of a sample of staff n=3605 from 169 nursing homes in 35 municipalities, and nursing home managers n=191. The second data collection consists of 11 semi-structured interviews with 12 nursing home managers in highly person-centred nursing homes that already participated in SWENIS. Data were explored via descriptive statistics, simple and multiple regression analyses, and qualitative content analysis.

    Results: Leadership was positively associated with person-centred care and psychosocial climate. Highly rated leadership behaviors’ among nursing homes managers was characterized by experimenting with new ideas, controlling work closely, relying on his/her subordinates, coaching and giving direct feedback, and handling conflicts constructively. Leading person-centred care can be outlined by four leadership processes: embodying person-centred being and doing; promoting a person-centred atmosphere; maximizing person-centred team potential and optimising person-centred support structures. Leadership was also positively associated with social support and negatively associated with job strain. Further, the variation in leadership was to a very small extent explained by the nursing home managers’ educational qualification, operational form of the nursing home and the number of employees in a unit.

    Conclusions: All findings point in the same direction: that leadership, as it is characterized and measured in this thesis, is significantly associated with person-centred care provision as well as with the work situation of staff. This suggests that nursing managers have a central leadership role in developing and supporting person-centred care practices, and also in creating a healthy work environment. The results also highlight five specific leadership behaviours that are most characteristic of highly rated leadership, thereby adding concrete descriptions of behaviours to the literature on existing leadership theories. The findings also include four central processes for leading towards person-centred care in nursing homes. Taken together, it seems important for managers to translate the person-centred philosophy into actions and to promote an atmosphere pervaded by innovation and trust, in which cultural change is enhanced by positive cultural bearers. Utilizing the overall knowledge and competencies among staff and potentiating care teams was also considered important for leading person-centred care, along with optimising supportive structures for supporting and maintaining person-centred care. If aged care organisations are to be committed to person-centred care, an important implication seems to be to organise nursing homes in a way that allows nursing home managers to be close and present in clinical practice and actively lead towards person-centred care. The findings of this thesis contribute to our understanding of leadership in relation to person-centre care and the work situation of staff. These findings can be used in leadership educations and nursing curriculum. Longitudinal studies would be valuable for following leadership, person-centred care and the work situation of staff over time.

  • 125.
    Backman, Annica
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Ahnlund, Petra
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Sjögren, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lövheim, Hugo
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    McGilton, Katherine S.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifery, La Trobe University, Melbourne, Australia .
    Leading towards person-centred care – Nursing home managers' experiences of leading person-centred care in highly person-centred Swedish nursing homesManuscript (preprint) (Other academic)
    Abstract [en]

    Background:Although a growing body of research knowledge exists highlighting the importance of leadership for person-centred care, studies focused on nursing home managers’ own descriptions of leading their staff to provide person-centred care is lacking. This study aims to explore the process of nursing home managers’ leading person-centred care in Swedish nursing homes.

    Methods:The methods of the study consisted of semi-structured interviews with 12 nursing home managers within 11 highly person-centred nursing homes purposively selected from a national wide survey of nursing homes in Sweden. A qualitative content analysis was performed for data analyses.

    Results:The study revealed that the leading person-centred care in nursing homes can be outlined as comprising four processes: Embodying person-centred being and doing; promoting a person-centred atmosphere; maximizing person-centred team potential; and finally, optimizing person-centred support structures.

    Conclusion:This study contributes to the literature by providing concrete descriptions of how person-centred care can be operationalised and supported in everyday practice by the leadership of nursing home managers. The study is significant in that it provides evidence on how the provision of person centred care can be facilitated by managers and the important role they play in developing and maintaining this philosophy of care within nursing homes.

  • 126.
    Backman, Annica C.
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lövheim, Hugo
    Sjögren, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. La Trobe Univ, Melbourne, Vic, Australia.
    Leadership behavior in relation to person-centeredness and person-centered climate - a cross-sectional study in residential aged care in Sweden2015In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 55, p. 806-807Article in journal (Other academic)
  • 127.
    Backman, Annica
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lövheim, Hugo
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Sjögren, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindkvist, Marie
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing.  School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia.
    Characteristics of highly rated leadership in Swedish nursing homes2016In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 56, p. 283-283Article in journal (Other academic)
  • 128.
    Backman, Annica
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sjögren, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindkvist, Marie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.
    Lövheim, Hugo
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifery, La Trobe University, Melbourne, Australia.
    Characteristics of highly rated leadership in nursing homes using item response theory2017In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 12, p. 2903-2913Article in journal (Refereed)
    Abstract [en]

    Aim: To identify characteristics of highly rated leadership in nursing homes. Background: An ageing population entails fundamental social, economic and organizational challenges for future aged care. Knowledge is limited of both specific leadership behaviours and organizational and managerial characteristics which have an impact on the leadership of contemporary nursing home care. Design: Cross-sectional. Method: From 290 municipalities, 60 were randomly selected and 35 agreed to participate, providing a sample of 3605 direct-care staff employed in 169 Swedish nursing homes. The staff assessed their managers' (n = 191) leadership behaviours using the Leadership Behaviour Questionnaire. Data were collected from November 2013 - September 2014, and the study was completed in November 2016. A two-parameter item response theory approach and regression analyses were used to identify specific characteristics of highly rated leadership. Results: Five specific behaviours of highly rated nursing home leadership were identified; that the manager: experiments with new ideas; controls work closely; relies on subordinates; coaches and gives direct feedback; and handles conflicts constructively. The regression analyses revealed that managers with social work backgrounds and privately run homes were significantly associated with higher leadership ratings. Conclusion: This study highlights the five most important leadership behaviours that characterize those nursing home managers rated highest in terms of leadership. Managers in privately run nursing homes and managers with social work backgrounds were associated with higher leadership ratings. Further work is needed to explore these behaviours and factors predictive of higher leadership ratings.

  • 129.
    Backman, Annica
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sjögren, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindkvist, Marie
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Lövheim, Hugo
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifer y, La Trobe University, Melbourne, VIC, Australia.
    Towards person-centredness in aged-care: exploring the impact of leadership2016In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 24, no 6, p. 766-774Article in journal (Refereed)
    Abstract [en]

    Aim: To explore the association between leadership behaviours among managers in aged care, and person‐centredness of care and the psychosocial climate.

    Background: Theory suggests that leadership is important for improving person‐centredness in aged care, however, empirical evidence is lacking.

    Methods: A cross‐sectional design was used to collect data from Swedish aged care staff (= 3661). Valid and reliable questionnaires assessing leadership behaviours, person‐centeredness of care and the psychosocial climate were used. Data were analysed using multiple linear regression including interaction terms.

    Results: Leadership behaviours were significantly related to the person‐centredness of care and the psychosocial climate. The level of person‐centredness of care moderated the impact of leadership on the psychosocial climate.

    Conclusions and implications for nursing management: The leadership behaviour of managers significantly impacts person‐centred care practice and contributes to the psychosocial climate for both staff and residents in aged care. This study is the first empirically to confirm that middle managers have a central leadership role in developing and supporting person‐centred care practice, thereby creating a positive psychosocial climate and high quality care.

  • 130.
    Backman, Annica
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sjögren, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lövheim, Hugo
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifery, La Trobe University, Melbourne, Vic., Australia.
    Job strain in nursing homes: exploring the impact of leadership2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 7-8, p. 1552-1560Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: To explore the association between nursing home managers' leadership, job strain and social support as perceived by direct care staff in nursing homes.

    Background: It is well known that aged care staff experience high levels of job strain, and that aged care staff experiencing job strain are exposed to increased risk for adverse health effects. Leadership styles have been associated with job strain in the literature; however, the impact of perceived leadership on staff job strain and social support has not been clarified within nursing home contexts.

    Design: This study had a cross‐sectional design.

    Methods: Participating staff (n = 3,605) completed surveys which included questions about staff characteristics, valid and reliable measures of nursing home managers' leadership, perceived job strain and social support. Statistical analyses of correlations and multiple regression analysis with interaction terms were conducted.

    Results: Nursing home managers' leadership were significantly associated with lower level of job strain and higher level of social support among direct care staff. A multiple regression analysis including an interaction term indicated individual and joint effects of nursing home managers' leadership and social support on job strain.

    Conclusions: Nursing home managers' leadership and social support were both individually and in combination associated with staff perception of lesser job strain. Thus, nursing home managers' leadership are beneficial for the working situation and strain of staff.

    Relevance to clinical practice: Promoting a supporting work environment through leadership is an important implication for nursing home managers as it can influence staff perception of job strain and social support within the unit. By providing leadership, offering support and strategies towards a healthy work environment, nursing home managers can buffer adverse health effects among staff.

  • 131.
    Backman, Sandra
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Skystedt, Mathilda
    Umeå University, Faculty of Medicine, Department of Nursing.
    Att förändras över en natt: Erfarenheter av att ha genomgått obesitaskirurgi- En litteraturstudie.2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Att förändras över en natt, erfarenheter av att ha genomgått obesitaskirurgi – En litteraturstudie.Bakgrund: Övervikt och fetma är ett allvarligt hälsoproblem som kan förebyggas genom samhälleliga insatser och livsstilsförändringar. Det har visat sig att för de som är kraftigt överviktiga kan obesitaskirurgi vara ett alternativ. Studier visar att obesitaskirurgi resulterar i både positiva och negativa följder.Syfte: Denna litteraturstudies syfte var att belysa ungdomars och vuxnas erfarenheter av att ha genomgått obesitaskirurgi.Metod: En litteraturstudie genomfördes med elva kvalitativa artiklar. Artiklarna granskades och deras resultat analyserades och sammanställdes.Resultat: Erfarenheterna beskrivs i tre kategorier och sju underkategorier, personerna som genomgått obesitaskirurgi fick ett förändrat förhållande till mat, en förändrad relation till omgivningen samt fysiska och psykiska konsekvenser såsom viktnedgång och förbättrad självkänsla.Slutsats: Obesitaskirurgi medför förändrad kroppsbild och det krävs stora ansträngningar och stark vilja för att inte återfå övervikten som många tappar efter operationen. Kunskapen om erfarenheter av att genomgå obesitaskirurgi är viktigt för sjuksköterskor, för att kunna stötta ungdomar och vuxna att finna sin inre motivation, hitta meningsfullhet samt att coacha dessa individer när de ställs inför den förändrade kroppsbilden.

  • 132.
    Backström, Johanna
    Umeå University, Faculty of Medicine, Department of Nursing.
    ATT ÅLDRAS MED HIV: Erfarenheter och kunskapsbehov hos distriktssköterskor inom hemsjukvården2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    ABSTRAKT

    Titel: ATT ÅLDRAS MED HIV. Erfarenheter och kunskapsbehov hos distriktssköterskor inom hemsjukvården.

    Bakgrund: I Sverige lever drygt 6500 personer med HIV. Effektiv behandling gör att antalet äldre som lever med HIV ökar. Idag betraktas HIV som en kronisk sjukdom, vilket ställer krav på kunskap om de åldersrelaterade problem det kan medföra för den äldre. Tidigare studier visar att sjuksköterskor och distriktssköterskor till viss del saknar grundläggande kunskap om HIV, smittsamhet och smittvägar. Brist på erfarenhet och kunskap kan påverka bemötandet och kvalitén på vård av äldre som lever med HIV.

    Syfte: Att belysa erfarenheter och kunskapsbehov hos distriktssköterskor inom hemsjukvården beträffande äldre som lever med HIV.

    Design: Kvalitativ design med induktiv ansats.

    Metod: Studien bygger på semistrukturerade intervjuer med sju distriktssköterskor och två sjuksköterskor inom kommunal hemsjukvård i ett län i norra Sverige. Intervjuerna spelades in, transkriberades och analyserades med hjälp av kvalitativ innehållsanalys.

    Resultat: Analysen resulterade i tre huvudkategorier, Medvetandegöra okunskap, Önskan om fortbildning och Önskan om tydliga riktlinjer och sju subkategorier. Resultatet belyses med citat från intervjuerna.

    Slutsats: För att säkerställa en god vård och ett bemötande utan rädsla och fördomar krävs uppdaterad grundläggande kunskap om HIV. Det finns också ett behov av tydliga rutiner som är lätta att hitta och behov av stöd från personal med mer erfarenhet. Vård av äldre som lever med HIV bör präglas av ett personcentrerat förhållningssätt där brukarens erfarenheter och kunskap tas tillvara.

    Nyckelord: distriktssköterska, erfarenhet, HIV, hemsjukvård, kunskap, personcentrerad, åldrande, äldre

  • 133.
    Backteman-Erlanson, Susann
    Umeå University, Faculty of Medicine, Department of Nursing.
    Burnout, work, stress of conscience and coping among female and male patrolling police officers2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background. Police work is a stressful occupation with frequent exposure to traumatic events and psychological strain from work might increase the risk of burnout. This thesis focuses on patrolling police officers (PPO), who work most of their time in the community and have daily contact with the public. Since police work traditionally is a male coded occupation we assume that there are differences between women and men in burnout as well as experiences from psychosocial work environment.

    Aim. The overall aim of this thesis is to explore burnout, psychosocial and physical work environment, coping strategies, and stress of conscience when taking gender into consideration among patrolling police officers.

    Methods. This thesis employs both qualitative and quantitative methods. In Paper I a qualitative approach with narrative interviews was used where male PPO described experiences of traumatic situations when caring for victims of traffic accidents. A convenience sample of nine male PPO from a mid-sized police authority was recruited. Interviews were analyzed using qualitative content analysis. Papers II, III, and IV were based on a cross-sectional survey from a randomly selected sample stratified for gender from all 21 local police authorities in Sweden. In the final sample, 1554 PPOs were invited (778 women, 776 men), response rate was 55% (n=856) in total, 56% for women (n=437) and 53% for men (n=419). The survey included a self-administered questionnaire based on instruments measuring burnout, stress of conscience, psychosocial and physical work environment, and coping.

    Results. Findings from Paper I were presented in three themes; “being secure with the support system,” “being confident about prior successful actions,” and “being burdened with uncertainty.” Results from Paper II showed high levels of emotional exhaustion (EE), 30% for female PPOs and 26% for male PPOs. High levels of depersonalization (DP) were reported for 52 % of female PPO, corresponding proportions for male were 60%. Multiple logistic regression showed that stress of conscience (SCQ-A), high demand, and organizational climate increased the risk of EE for female PPO. For male PPO stress of conscience (SCQ-A), low control and high demand increased the risk of EE. Independent of gender, stress of conscience (SCQ-A) increased the risk of DP. Psychometric properties of the WOCQ were investigated with exploratory factor analysis and confirmatory factor analysis, a six-factor solution was confirmed. DIF analysis was detected for a third of the items in relation to gender. In Paper IV a block wise hierarchical multiple regression analysis was performed investigating the predictive impact of psychological demand, decision latitude, social support, coping strategies, and stress of conscience on EE as well as DP. Findings revealed that, regardless of gender, risk of EE and DP increased with a troubled conscience amongst the PPO.

    Conclusion. “Being burdened with uncertainty” in this male-dominated context indicate that the PPO did not feel confident talking about traumatic situations, which might influence their coping strategies when arriving to a similar situation. This finding can be related to Paper II and IV showing that stress of conscience increased the risk of both EE and DP. The associations between troubled conscience and the risk of experiencing both emotional exhaustion and depersonalization indicate that stress of conscience should be considered when studying the influence of the psychosocial work environment on burnout. Results from this study show that the psychosocial work environment is not satisfying and needs improvement for patrolling police officers in Sweden. Further studies including both qualitative and quantitative (longitudinal) methods should be used to improve knowledge in this area to increase conditions for preventive and rehabilitative actions.

  • 134.
    Backteman-Erlanson, Susann
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Jacobsson, Ann
    Umeå University, Faculty of Medicine, Department of Nursing.
    Öster, Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Caring for traffic accident victims: the stories of nine male police officers2011In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 19, no 2, p. 90-95Article in journal (Refereed)
    Abstract [en]

    Psychological strain due to the work environment is common, especially in those occupations which involve working in critical situations. Working as a police officer seems to increase the risk of psychological problems such as symptoms of stress and post traumatic stress disorders. The aim of this study was to describe male police officers’ experiences of traumatic situations when caring for victims of traffic accidents, and to reflect the results through the perspective of gender theories. Nine police officers were asked to narrate and reflect upon their experiences in taking care of people who had been severely injured in traffic accidents. The interviews were analysed with qualitative content analysis. The findings are presented in three themes: “being secure with the support system”, “being confident about prior successful actions, and “being burdened with uncertainty”. The officers’ descriptions showed that most of them had strategies that they used when they were first responders, developed on the basis of their own knowledge and actions and the support systems in their organization which enabled them to act in traumatic situations. When support systems, knowledge, and actions were insufficient, they sometimes felt insecure and “burdened with uncertainty”. In this male-dominated context, there was a risk that the officers may not talk enough about traumatic situations, thus influencing their ability to cope successfully.

  • 135.
    Backteman-Erlanson, Susann
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Padyab, Mojgan
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Prevalence of burnout and associations with psychosocial work environment, physical strain, and stress of conscience among Swedish female and male police personnel2012In: Police Practice & Research, ISSN 1561-4263, E-ISSN 1477-271XArticle in journal (Refereed)
    Abstract [en]

    Focus of this study was to investigate prevalence of burnout and relation to psychosocial work environment, physical strain, and stress of conscience amongst female and male police personnel in Sweden. The questionnaire was answered by 856 (55%) patrolling police officers, 437 (56%) women vs. 419 (53%) men. Prevalence and mean values for emotional exhaustion (EE) and depersonalization (DP) was higher in our study compared to other studies including police personnel in Norway and the Netherlands. A multiple logistic regressions showed that for women stress of conscience, high demand, and organizational climate was significant associated with EE, for men it was stress of conscience, decision, and high demand. For DP only stress of conscience contributed statistically significant in our model, respectively, of gender. Further research is needed to develop interventions aiming to reduce levels of burnout among police personnel in Sweden.

  • 136.
    Backteman-Erlanson, Susann
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Öster, Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Padyab, Mojgan
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Exploration of the WOCQ tool in relation to gender and psychometric properties among Swedish patrolling police officersManuscript (preprint) (Other academic)
    Abstract [en]

    Police work is a stressful occupation with frequent exposure to traumatic events. In Sweden knowledge about coping strategies among police personnel is absent probably due to lack of validated measurements. Aim of this study was to explore psychometric properties of the Ways of Coping Questionnaire (WOCQ) among Swedish police personnel, including testing differential item functioning (DIF) for gender. The WOCQ was sent out to 1554 randomly selected patrolling police officers in Sweden. Exploratory factor analysis and confirmatory factor analysis were used. A six factor solution was confirmed with differences and similarities compared to the original eight factor solution. DIF analysis showed similarities and differences in relation to gender. We suggest that the WOCQ can be used when investigating coping strategies in a Swedish police context.

     

  • 137.
    Bagger, Cecilia
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Svensson, Marie
    Umeå University, Faculty of Medicine, Department of Nursing.
    Anestesisjuksköterskans bemötande av patienter med preoperativ oro: - En litteraturstudie kring preoperativ oro och metoder att lindra denna2014Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 138.
    Bagglund, Jessica
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Blomqvist, Hanna
    Umeå University, Faculty of Medicine, Department of Nursing.
    Att åldras i marginalen: Upplevelsen av att vara äldre och icke-heterosexuell2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The group of elderly non-heterosexuals in Sweden is estimated to include 80,000 people. Within the nursing programme, there is limited knowledge about older LGBT people.

    Aim: The aim of this study was to describe the experience of being elderly and non-heterosexual.

    Method: In this literature study eight qualitative articles, published between 2001 and 2009, were compiled. Literature searches were performed in the databases CINAHL, PsychINFO and PubMed. After perusal, determination of the quality and analysis of the content, the articles were compiled into five categories and 16 subcategories.

    Results: Older non-heterosexuals viewed and dealt with their sexual identity in different ways. Overall, many participants in the studies experienced a high level of confidence and satisfaction with their lives but many experienced ageism and felt discriminated within nursing contexts. Several of the participants felt that they did not have the same legal rights as heterosexuals do. Some non-heterosexuals chose to deliberately conceal their sexual orientation due to fear of negative attitudes while others lived openly with their sexual identity.

    Conclusion: It is necessary to make the older non-heterosexuals visible. In order to make elderly non-heterosexuals feel secure and equally treated in health care, increased awareness and changes in attitudes are important. Hopefully, the findings will result in better knowledge and greater understanding of elderly non-heterosexuals in the nursing context. Further research is needed on older LGBT persons.

  • 139.
    Bahamon, Alejandra
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Granvik, Gabriella
    Umeå University, Faculty of Medicine, Department of Nursing.
    "Hör du mig": En litteraturstudie om närståendes upplevelse av kommunikation med omvårdspersonal i palliativ vård2019Independent thesis Basic level (university diploma), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [en]

    Background: Palliative care is when the care goes from curative to only relieving. The aim of this approach is to facilitate better quality of life for both the patient and the relatives. Relatives are an important part of palliative care, however they can experience the situation hard and difficult emotionally. Healthcare professionals have an important role to play in alleviating suffering and conveying important information. There may be different barriers that affect communication, such as lack of understanding and knowledge of healthcare professionals and relatives.

    Aim: The purpose of the literature study was to investigate the relatives experience of communication with healthcare professionals in palliative care.

    Method: This literature study included 10 qualitative articles analyzed with content analysis.

    Result: The results of the study are presented in four main categories: 1) information, 2) conversation, 3) the approach of healthcare professional, 4) relatives' need for communication & information and six subcategories; 1) good information, 2) lack of information, 3) positive experiences of conversations, 4) negative experiences of conversation, 5) the positive influence of the healthcare professionals, 6) the negative influence of the healthcare professionals.

    Conclusion: Relatives had different experiences of communication in palliative care. It became clear that the healthcare professionals acting had an important part in the experience of communication for the relatives. In order to contribute to better communication, healthcare professionals need more education in conversation art.

  • 140.
    Bang, Isabell
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Allanius Koskenniemi, Åsa
    Umeå University, Faculty of Medicine, Department of Nursing.
    Anestesisjuksköterskors erfarenheter av att söva barn.2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The majority of the children who undergo surgery experience severe anxiety prior to surgery. Preoperative anxiety should be avoided to reduce the psychological trauma. The nurse anesthetist should create a good contact and help the family cope with the frightening situation. There are both pharmacological and non-pharmacological ways to reduce anxiety.

    Aims: The purpose of the study is to describe the anesthetic nurses' experiences of anesthetizing children.

    Method: The study is based on interviews with twelve nurse anesthetists, operating at three of the sections on surgery center at one of Sweden's regional hospital. The interviews were based on semi-structured questions and analyzed using qualitative content analysis.

    Findings: Six categories emerged: parents, profession and compliance to different situations, the important meeting, premedication and external factors.

    Conclusion: An optimized premedication was highlighted as the most important factor for a successful anesthetic induction of children. If the child already had an intravenous line upon arrival at the surgical department it simplified the induction significantly. How well the parents handled the situation was also important for how the situation turned out.

  • 141.
    Baradaran, Nadja
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lundgren, Sofie
    Umeå University, Faculty of Medicine, Department of Nursing.
    Att vårda under rädsla: - En litteraturstudie om vårdpersonals upplevelser av hot och våld inom psykiatrisk vård.2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Title: Working under fear- a literature review about nursing staff’s experiences of threat and violence in psychiatric care.

    Background: Reports show that threat and violence is a common phenomenon in healthcare. It appears in every part of healthcare, but some units are at more risk than others, for example psychiatric care. The verbal and physical violence creates an insecure work environment and can cause serious consequences for both personnel and patients.

    Aim: To describe psychiatric nursing staff’s perceptions of threat and violence in psychiatric care. Methods: A literature review based on eight qualitative articles. These articles were examined, analyzed and compiled.

    Results: Threat and violence caused strong emotional reactions, like fear and anger, among nursing staff that influenced the work and their private life. The unsafe work environment composed a threat to the nursing staff’s professional role and self image. It was percieved that violence were unavoidable, and that nursing staff were expected to accept violence as a part of the job. Violence were handled and prevented with different strategies, while manegement support were lacking.

    Conclusion: Violence against nursing staff in psychiatric care are a relatively unexplored subject in need of more research. Nursing staff are suffering both physical and psychological damage due to violence in the workplace, which also effects the care given to patients and the nursing staff’s own health. To improve the work situation the nursing staff need more education in handling violence.

    Keywords: Nursing staff, Psychiatry, Threat and violence, Workrelated violence

  • 142. Barremo, Ann-Sofi
    et al.
    Bruce, Elisabeth
    Västernorrlands läns landsting, Örnsköldsvik (Västernorrland County Council).
    Salander, Monica
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sundin, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Personers upplevelse av att leva med kronisk hjärtsvikt: Systematisk litteraturstudie2008In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 28, no 3, p. 34-38Article in journal (Refereed)
    Abstract [en]

    Background: Heart failure is a clinical syndrome where the heart is no longer able to maintain adequate blood circulation to the tissue. Many suffer from symptoms difficult to handle such as dyspnoea, fatigue, and physical weakness.

    Aim: The purpose of the study was to investigate peoples’ experiences of living with congestive heart failure.

    Method: A systematic literature review was used. Relevant articles were found in the Medline and Cinahl databases. The articles were examined, classified and critically appraised. Twenty articles were included. A qualitative content analysis was used to organize the results.

    Results: The results are described in three main categories: losses, protecting independences and readjustment. The category ‘losses’ details physical, emotional and social changes that people experience as losses caused by the debilitating symptoms of heart failure. The category ‘protecting independences’ shows the different ways in which people try to keep control over their lives. The category ‘readjustment’ presents how people try to seek a new ‘wholeness’ in life after the changes heart failure have caused by using acceptance, adaptation and finding new meanings.

    Conclusion: Living with congestive heart failure can be experienced as a synopsis of the «suffering human being» on a continuum, a time axle; from falling ill to seeking a new meaning in life.

  • 143. Barremo, Ann-Sofi
    et al.
    Bruce, Elisabeth
    Sundin, Karin
    Umeå University, Faculty of Medicine, Omvårdnad.
    Persons' experiences of living with congestive heart failure: a systematic literature review2008In: Vård i Norden, Vol. 28, no 3, p. 34-8Article, review/survey (Other (popular science, discussion, etc.))
  • 144.
    Baxter, Rebecca
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Björk, Sabine
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing.
    Commentary on: Sullivan and Willis (2018). Towards Changing the Long-Term Care (LTC) Paradigm: Explicating the Concept of Thriving in Older Adults Living in LTC2019In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 40, no 7, p. 639-640Article in journal (Refereed)
  • 145.
    Baxter, Rebecca
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifery, La Trobe University, Melbourne, Australia.
    Impact of a critical care postgraduate certificate course on nurses' self-reported competence and confidence: A quasi-experimental study2018In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 65, p. 156-161Article in journal (Refereed)
    Abstract [en]

    Background: Postgraduate education is said to support the development of nurses' professional competence and confidence, essential to the delivery of safe and effective care. However, there is a shortness of empirical evidence to demonstrate an increase to nurses' self-reported confidence and competence on completion of critical care postgraduate certificate-level education.

    Objectives: To explore the impact of a critical care postgraduate certificate course on nurses' self-reported competence and confidence. To explore the psychometric properties and performance of the Critical Care Competence and Confidence Questionnaire.

    Design: A quasi-experimental pre/post-test design.

    Participants: A total population sample of nurses completing a critical care postgraduate certificate course at an Australian University.

    Methods: The Critical Care Competence and Confidence Questionnaire was developed for this study to measure nurses' self-reported competence and confidence at baseline and follow up. Descriptive and inferential statistics were used to explore sample characteristics and changes between baseline and follow-up. Reliability of the questionnaire was explored using Cronbach's Alpha and item-total correlations.

    Results: There was a statistically significant increase in competence and confidence between baseline and follow-up across all questionnaire domains. Satisfactory reliability estimates were found for the questionnaire.

    Conclusions: Completion of a critical care postgraduate certificate course significantly increased nurses' perceived competence and confidence. The Critical Care Competence and Confidence Questionnaire was found to be psychometrically sound for measuring nurses' self-reported competence and confidence.

  • 146.
    Baxter, Rebecca
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lövheim, Hugo
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Björk, Sabine
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Sköldunger, Anders
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindkvist, Marie
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Sjögren, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sandman, Per-Olof
    Umeå University, Faculty of Medicine, Department of Nursing. Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden.
    Bergland, Ådel
    Winblad, Bengt
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing & Midwifery, La Trobe University, Melbourne, Australia.
    The Thriving of Older People Assessment Scale: Psychometric evaluation and short‐form development2019In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Article in journal (Refereed)
    Abstract [en]

    Aim: To evaluate the psychometric properties and performance of the 32‐item Thriving of Older People Assessment Scale (TOPAS) and to explore reduction into a short‐form.

    Background: The 32‐item TOPAS has been used in studies of place‐related well‐being as a positive measure in long‐term care to assess nursing home resident thriving; however, item redundancy has not previously been explored.

    Design: Cross‐sectional.

    Method: Staff members completed the 32‐item TOPAS as proxy‐raters for a random sample of Swedish nursing home residents (N = 4,831) between November 2013 and September 2014. Reliability analysis, exploratory factor analysis and item response theory‐based analysis were undertaken. Items were systematically identified for reduction using statistical and theoretical analysis. Correlation testing, means comparison and model fit evaluation confirmed scale equivalence.

    Results: Psychometric properties of the 32‐item TOPAS were satisfactory and several items were identified for scale reduction. The proposed short‐form TOPAS exhibited a high level of internal consistency (α=0.90) and strong correlation (r=0.98) to the original scale, while also retaining diversity among items in terms of factor structure and item difficulties.

    Conclusion: The 32‐item and short‐form TOPAS' indicated sound validity and reliability to measure resident thriving in the nursing home context.

    Impact: There is a lack of positive life‐world measures for use in nursing homes. The short‐form TOPAS indicated sound validity and reliability to measure resident thriving, providing a feasible measure with enhanced functionality for use in aged care research, assessments and care planning for health promoting purposes in nursing homes.

  • 147.
    Bay, Annika
    Umeå University, Faculty of Medicine, Department of Nursing.
    Being physically active as an adult with congenital heart disease2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Due to advances in medical and surgical care adults with congenital heart disease (CHD) is a growing and aging population, that now outnumbers the children with CHD. In general, adults with CHD have reduced aerobic exercise capacity and nearly half of the patients do not reach current recommendations on physical activity. It is known that a low level of physical activity is associated with an increased risk for acquired cardiovascular disease. Studies has shown that adults with CHD are at the same, or even higher risk as the general population, for developing acquired cardiovascular disease.

    Aim: The overall aim was to explore physical activity in adults with CHD with respect to associated factors, exercise self-efficacy and their own experiences.

    Methods: This thesis is based on four papers. Paper I included 471 adults with CHD from three tertiary care centres in Sweden. The participants completed questionnaires measuring patient reported outcomes (e.g. SF-12) including physical activity level. Paper II was based on data from 79 adults with CHD from two tertiary care centers in Sweden and 42 matched controls. All participants completed questionnaires on exercise self-efficacy and quality of life, wore an activity monitor during four consecutive days and performed muscle endurance tests. Paper I and II were of cross-sectional design and analyses were done using logistic regression. In paper III and IV data were collected through structured interviews for 14 participants. They were asked about their experiences of being physically active (paper III), what they considered as physical activities, and their experiences of enablers and barriers to physical activity (paper IV). Qualitative content analysis was used in papers III and IV.

    Results: Physical activity level (paper I) and exercise self-efficacy (paper II) were strongly associated with age where those over 40 years had a lower level of physical activity and lower exercise self-efficacy. Further, in paper I, it appeared that patient reported outcomes from SF-12 were strongly associated with physical activity level. In paper II, exercise self-efficacy was associated with performance in a muscle endurance tests. Paper III revealed an overall theme – It´s like balancing on a slackline that illustrates how adults with CHD described themselves in relation to physical activity. This overall theme consisted of four themes: (1) Being an adventurer – enjoying the challenges of physical activity; (2) Being a realist – adapting to physical ability; (3) Being a non-doer – lacking prerequisites for physical activity and (4) Being an outsider – feeling excluded depending on physical ability. In paper IV, the analysis revealed a description of what adults with CHD consider to be physical activity and considered as enablers and barriers for physical activity. Four categories appeared; physical aspects, psychological aspects, psychosocial aspects and environmental aspects. In the psychosocial aspect, social support and encouragement in childhood to be physically active and no restrictions from e.g. parents, teachers and health care increased physical activity in adulthood.

    Conclusions: Age, social support and accepting physical limitations seem to have an important impact regarding physical activity level and exercise self-efficacy. In contrast, the complexity of CHD and other medical factors appear to be of less importance for adults with CHD in relation to physical activity. In order to support adults with CHD to increase their physical activity and reach their full potential, it is important to explore and consider the various aspects that may affect physical activity in this population.

  • 148.
    Bay, Annika
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Fysiskt aktiv som vuxen med medfött hjärtfel: ”Som att balansera på slak lina”2018Conference paper (Other academic)
  • 149.
    Bay, Annika
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    PATIENTRAPPORTERADE UTFALLSMÅTT ÄR ASSOCIERADE MED FYSISK AKTIVITETSNIVÅ HOS VUXNA MED MEDFÖDDA HJÄRTFEL2017Conference paper (Other academic)
  • 150.
    Bay, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Berghammer, M.
    Lämås, Kristina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sandberg, Camilla
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Johansson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Facilitators and barriers for physical activity in adults with congenital heart disease2018In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 39, p. 1120-1121Article in journal (Other academic)
    Abstract [en]

    Background: A majority of adults with congenital heart disease (CHD) have reduced exercise capacity and do not reach the recommended level of physical activity. A physically active lifestyle is essential to maintain health and counteract acquired cardiovascular disease. This study illuminates aspects that may be relevant for performing physical activity.

    Purpose: To describe facilitators and barriers for physical activity in adults with CHD.

    Methods: Semi-structured interviews were performed individually with fourteen adults (age 19–68 years, women=7) with complex CHD. The interviews were analyzed using qualitative content analysis.

    Results: Aspects that may enable or inhibit physical activity were found in two domains; Facilitators and Barriers, which both consisted of four categories physical, psychological, psychosocial and environmental aspects (Table 1).

    This can be exemplified by the category physical aspects; where persons expressed being limited by the CHD to perform physical activity, but also that improved aerobic fitness allows for being more active, and in the category psychosocial aspects; the person's previous negative experiences and lack of support constituted barriers while encouragement from others and being active as a child facilitated an active lifestyle in adult age.

    Conclusion: The present study identifies barriers and facilitators for being physically active in adults living with CHD. It is essential to identify prerequisites for supporting and promoting physical activity and thereby hopefully prevent long-term adverse outcomes. Barriers can potentially be transformed to facilitators through increased knowledge in both the adult with CHD and the healthcare provider.

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